| NPI | 1376928101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA DORLINE JOHNSON Owner 757-534-7840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 090400826) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2024-07-09 |